Wendler J J, Damm R, Liehr U-B, Brunner T, Pech M, Schostak M
Universitätsklinik für Urologie u. Kinderurologie, Universitätsmedizin Magdeburg (UMMD) A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.
Universitätsklinik für Radiologie u. Nuklearmedizin, Universitätsmedizin Magdeburg (UMMD) A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.
Urologe A. 2018 Jun;57(6):731-743. doi: 10.1007/s00120-018-0677-4.
The incidence of renal cell carcinoma has been rising for years. At the same time there is an increasing prevalence of chronic renal failure with subsequent higher morbidity and shorter life expectancy in those affected. In the last decades the gold standard has thus shifted from radical to partial nephrectomy or tumor enucleation. A treatment alternative can be advantageous for selected patients with high morbidity and an increased risk of complications in anesthesia or surgery. Active surveillance represents a controlled delay in the initiation of treatment with a curative intention. Percutaneous radiofrequency ablation and laparoscopic cryoablation are currently the most commonly used treatment alternatives. Newer ablation procedures, such as high-intensity focused ultrasound, irreversible electroporation, microwave ablation, stereotactic ablative radiotherapy and high-dose brachytherapy have a high potential in some cases but are still considered experimental for the treatment.
多年来,肾细胞癌的发病率一直在上升。与此同时,慢性肾衰竭的患病率也在增加,随之而来的是患者更高的发病率和更短的预期寿命。在过去几十年中,金标准已从根治性肾切除术转向部分肾切除术或肿瘤剜除术。对于某些具有高发病率以及麻醉或手术并发症风险增加的特定患者,一种治疗替代方案可能具有优势。主动监测意味着以治愈为目的的治疗开始的可控延迟。经皮射频消融和腹腔镜冷冻消融是目前最常用的治疗替代方案。较新的消融程序,如高强度聚焦超声、不可逆电穿孔、微波消融、立体定向消融放疗和高剂量近距离放疗,在某些情况下具有很大潜力,但仍被视为治疗的实验性方法。